England’s Chief Inspector of Hospitals has told Hull and East Yorkshire Hospitals NHS Trust that it must make improvements following an inspection by the Care Quality Commission
Hull and East Yorkshire Hospitals NHS Trust is a provider of specialist and tertiary services to a catchment population of between 1.1 million and 1.3 million extending from Scarborough in North Yorkshire to Grimsby and Scunthorpe in North East and North Lincolnshire respectively. Inspectors visited the trust between 7 and 9 February 2018.The well-led inspection took place between 27 February and 1 March.
The trust was last inspected in June 2016 when it was rated as Requires Improvement. At this inspection the trust’s overall rating remained the same. For safety and responsiveness the organisation was rated Requires Improvement and for effectiveness, caring and well-led, the rating was Good.
The trust has two main hospital sites, Hull Royal Infirmary which was rated Requires Improvement and Castle Hill Hospital, which was rated Good. CQC rated three of the hospital’s five services as Good and two as Requires Improvement.
At trust level, safety stayed the same at Requires Improvement. The rating for effectiveness improved from Requires Improvement to Good. Inspectors noted good multi-disciplinary working and effective information sharing at daily huddles. With regard to caring it remained the same at Good. Responsiveness also remained the same at Requires Improvement.
The well-led area improved from Requires Improvement to Good. The trust had a stable and experienced leadership team. Inspectors saw a significant improvement in the culture of the organisation; all staff the inspection team spoke with were positive about the leadership team
At the 2016 inspection, inspectors had highlighted that the five steps to safer surgery including the World Health Organisation (WHO) was not being used effectively within the surgery health group. During this inspection we did not observe consistency across the trust with five steps to safer.
The trust had introduced a midwifery led unit, utilising some labour ward rooms but with recruitment of separate staff. This had been developed with input from local women, midwives and other local services. It was notable that the number of bed moves had reduced since the last inspection; inspectors could see that patient flow was being managed through the hospital.
Across the trust care for older people had improved from Requires Improvement to Good. Inspectors had previously raised concerns about medicine reconciliation and the recording of controlled drugs. These had been addressed.
Surgery had improved at Hull Royal Infirmary from Requires Improvement to Good. At the last inspection CQC had identified concerns in respect of how staff identified and escalated patients who were deteriorating. One of the indicators that this had improved was the expected risk of readmission following treatment. Across both hospitals this was better than expected for both elective and non-elective admissions when compared to the England average. Additionally, the overall numbers of patients whose operations were cancelled and not treated within 28 days was better than the England average.
Across both sites medical care for older people had improved from Requires Improvement to Good. Inspectors saw improvements with medicine compliance previously raised as a concern with the trust. Medicine reconciliation, recording of fridge temperatures and recording of controlled drugs had all seen improvement since the last inspection.
Professor Ted Baker, CQC, Chief Inspector of Hospitals, said:
“While the overall rating for Hull and East Yorkshire Hospitals NHS Trust has remained the same that is not to say there has not been improvement. In a number of areas, notably within surgery at Hull the trust and medical for older people, care had improved.
“At trust level the rating for well-led improved from Requires Improvement to Good.
We saw a significant improvement in the culture in the organisation; staff we met spoke positively about the leadership team and told us they felt supported, respected and valued. Encouragingly culture at the trust was centred on the needs and experiences of people who use services.
“The eye hospital had been given an ophthalmology award in 2017, for the introduction of the virtual reviewing service for patients with glaucoma. These awards celebrate outstanding work within ophthalmology practice.
“However, we identified areas where they will need to bring about improvement including; completing patient risk assessments particularly for falls, nutrition and mental capacity assessments.
“CQC will continue to monitor the service closely and return at some time in the future to check on progress.”
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We saw a significant improvement in the culture in the organisation
Professor Ted Baker, Chief Inspector of Hospitals